Department of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore, Singapore.
Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong.
Support Care Cancer. 2023 Aug 9;31(9):515. doi: 10.1007/s00520-023-07983-1.
To evaluate the overall efficacy of StrataXRT, a topical gel dressing, in preventing acute radiation dermatitis (RD) in breast cancer patients undergoing radiotherapy (RT).
A systematic search was conducted on April 25, 2023 in Ovid MEDLINE, Embase, and Cochrane Central Register of Controlled Trials. Randomized controlled trials (RCTs) assessing the effectiveness of StrataXRT in preventing acute RD in breast cancer patients undergoing adjuvant RT to the breast or chest wall with or without regional nodes were included. Pooled incidence odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effects model, with analysis and forest plots generated in RevMan v5.4.
The analysis included three RCTs with a total of 189 patients assessed using per-protocol analysis. Two RCTs compared StrataXRT to standard of care, while the third compared it with Mepitel film and was reported separately. In the former RCTs, the odds ratio (OR) for developing acute grade 3 RD favored StrataXRT at 0.05 (95% CI, 0.01-0.22; P < 0.0001). The OR for developing acute grades 2-3 RD was 0.32 (95% CI, 0.03-3.18; P = 0.33). The RCT comparing StrataXRT with Mepitel film showed insignificant ORs for grade 3 and grades 2-3 RD. One RCT reported significantly lower erythema index (P = 0.008) and melanin index (P = 0.015) in StrataXRT patients. The use of StrataXRT did not raise additional safety concerns.
StrataXRT may help prevent severe acute RD in breast cancer RT patients. Further high quality, large-scale studies are needed to confirm these findings.
评估 StrataXRT (一种局部凝胶敷料)在预防接受乳房或胸壁放疗(RT)联合或不联合区域淋巴结放疗的乳腺癌患者急性放射性皮炎(RD)方面的总体疗效。
于 2023 年 4 月 25 日在 Ovid MEDLINE、Embase 和 Cochrane 对照试验中心注册库进行系统检索。纳入评估 StrataXRT 预防接受乳房或胸壁 RT 联合或不联合区域淋巴结放疗的乳腺癌患者急性 RD 效果的随机对照试验(RCT)。采用随机效应模型计算汇总发生率比值比(OR)和 95%置信区间(CI),并在 RevMan v5.4 中进行分析和森林图绘制。
该分析纳入了三项共纳入 189 例患者的 RCT,采用方案分析进行评估。两项 RCT 将 StrataXRT 与标准护理进行比较,而第三项 RCT 将其与 Mepitel 膜比较,并分别进行了报告。在前两项 RCT 中,发生急性 3 级 RD 的优势比(OR)有利于 StrataXRT,为 0.05(95%CI,0.01-0.22;P<0.0001)。发生急性 2-3 级 RD 的 OR 为 0.32(95%CI,0.03-3.18;P=0.33)。与 Mepitel 膜比较的 RCT 显示 3 级和 2-3 级 RD 的 OR 无统计学意义。一项 RCT 报告 StrataXRT 组的红斑指数(P=0.008)和黑色素指数(P=0.015)显著降低。StrataXRT 的使用未引起额外的安全性问题。
StrataXRT 可能有助于预防乳腺癌 RT 患者的严重急性 RD。需要进一步开展高质量、大规模的研究来证实这些发现。